Efficacy and safety of apatinib combined with whole-brain radiation therapy with a simultaneous integrated boost for brain metastases from non-small cell lung cancer: a multicenter retrospective study.
Efficacy and safety of apatinib combined with whole-brain radiation therapy with a simultaneous integrated boost for brain metastases from non-small cell lung cancer: a multicenter retrospective study.
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阿帕替尼联合全脑放射治疗同时综合增强治疗非小细胞肺癌脑转移的疗效和安全性：一项多中心回顾性研究
DOI：
10.21037/jtd-22-96
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发表时间：
2022-03
影响因子：
2.5
通讯作者：
Han G
中科院分区：
文献类型：
--
作者：
Ma J;Bi J;Tuo X;Pi G;Li Y;Li Y;Zeng F;Gong H;Hu D;Han G
20-65%的非小细胞肺癌（NSCLC）患者发生脑转移（BM），预后不良。阿帕替尼是一种选择性抑制血管内皮生长因子受体2的酪氨酸激酶抑制剂（TKI），是安全的，并显着延长化疗难治性胃癌患者的生存。这项回顾性研究评价了阿帕替尼联合同步脑放疗在BM NSCLC患者中的安全性和疗效。本试验入组了经组织学证实的NSCLC的非复发性BM患者，对BM大小/数量没有任何限制。入选标准为年龄18-75岁、BM可测量且来自组织学证实的NSCLC（包括新诊断和既往治疗的NSCLC）且预期生存时间大于3个月的患者。口服阿帕替尼（500或250 mg/天）在开始全脑放射治疗（WBRT-SIB）前1周内开始，并持续至放射治疗完成后1周。除毒性外，分析的结局还包括颅内总缓解率（iORR）、颅内疾病控制率（iDCR）、颅内无进展生存期（iPFS）和总生存期（OS）。从2016年7月至2020年1月，16例患者入组本回顾性研究。脑放疗3个月后，iORR为75%，iDCR为100%，脑水肿指数（EI）较脑放疗前显著降低（4.2 vs. 1.9; P=0.02）。中位iPFS为16.5个月[95%置信区间（CI）：15.1-37.4个月]。中位OS为26个月（95% CI：17.0-54.0个月）。大多数患者对阿帕替尼耐受良好，但7例患者出现副作用，最常见的是1级或2级。仅2例患者发生3级不良事件（高血压和口腔粘膜炎），未观察到4级或5级毒性。阿帕替尼联合WBRT-SIB治疗NSCLC患者BM安全有效。
Brain metastases (BMs) develop in 20–65% of non-small cell lung cancer (NSCLC) patients and are associated with a poor prognosis. Apatinib, a tyrosine kinase inhibitor (TKI) that selectively inhibits the vascular endothelial growth factor receptor 2, is safe and significantly prolongs the survival of chemotherapy-refractory gastric cancer patients. This retrospective study evaluated the safety and efficacy of apatinib combined with concurrent brain radiotherapy in NSCLC patients with BMs. This trial enrolled patients with non-recurrent BM from histologically-confirmed NSCLC without any limits regarding the BM size/quantity. Eligibility criteria were patients 18–75 years old with measurable BM from histologically-confirmed NSCLC (including both newly-diagnosed and previously treated NSCLC) and expected survival time greater than 3 months. Oral apatinib (500 or 250 mg/day) was started within 1 week prior to commencing whole brain radiotherapy with simultaneous integrated boost (WBRT-SIB) and continued until one week after radiotherapy completion. In addition to toxicities, analyzed outcomes included intracranial overall response rate (iORR), intracranial disease control rate (iDCR), intracranial progression free survival (iPFS), and overall survival (OS). From July 2016 to January 2020, 16 patients were enrolled in this retrospective study. After 3 months of brain radiotherapy, the iORR was 75%, the iDCR was 100%, and the brain edema index (EI) was significantly reduced compared to that before brain radiation therapy (4.2 vs. 1.9; P=0.02). The median iPFS was 16.5 months [95% confidence interval (CI): 15.1–37.4 months]. The median OS was 26 months (95% CI: 17.0–54.0 months). Most of the patients tolerated apatinib well, but 7 patients had side effects, most commonly grade 1 or 2. Only 2 patients experienced grade 3 adverse events (hypertension and oral mucositis), and no grade 4 or 5 toxicities were observed. Apatinib combined with WBRT-SIB appears to be safe and effective in treating BMs in NSCLC patients.
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影响因子：
3.7
作者：
Sofia Vala I;Martins LR;Imaizumi N;Nunes RJ;Rino J;Kuonen F;Carvalho LM;Rüegg C;Grillo IM;Barata JT;Mareel M;Santos SC
通讯作者：
Santos SC
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45.3
作者：
Sperduto, Paul W.;Kased, Norbert;Mehta, Minesh
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Mehta, Minesh
影响因子：
158.5
作者：
Sandler, Alan;Gray, Robert;Johnson, David H.
通讯作者：
Johnson, David H.
影响因子：
4.2
作者：
Jun, Kyong-Hwa;Lee, Jung Eun;Yang, Seung-Ho
通讯作者：
Yang, Seung-Ho
影响因子：
3.6
作者：
Ma, Jia;Pi, Guoliang;Han, Guang
通讯作者：
Han, Guang